Ikeno Yohei, Arii Daisuke, Nakajima Hirofumi, Murooka Kunihiko, Nojima Michio, Kidokoro Akio
Dept. of Pharmacy,aculty of Medicine, Juntendo University Urayasu Hospital.
Gan To Kagaku Ryoho. 2014 May;41(5):611-5.
The closed-system transfer device (CSTD), which is used to prevent the exposure of medical staff to anticancer drugs, has been reported to allow safe preparation and administration of these drugs to patients. At many medical institutions, however, the use of such devices is limited to select anticancer drugs. This could be attributable to the longer preparation time compared to the conventional injection technique with a syringe and needle, as well as the fact that the anticancer drugs are too expensive to be covered by the remuneration available for medical services. Against this background, we measured the time required to prepare cyclophosphamide(CPA)and estimated the cost incurred. Our results indicated that the preparation time for either a single dose of 100 mg CPA or a combination of 100 mg CPA and 500 mg of another drug(100mg+500 mg group)was significantly longer than that for 500 mg of a single drug. On the other hand, use of a CSTD reduced the total cost (drug cost+CSTD cost)on switching to a single dose of 500 mg, resulting in a 5-year savings as follows: 3,755,217 yen for ChemoCLAVE®, 6,302,622 yen for PhaSeal®, and 2,698,451 yen for Chemosafe®. These findings suggest that the appropriate selection of drugs, including a large standard dose of CPA, allows shortened preparation time and reduced total drug cost as well as CSTD cost.
用于防止医护人员接触抗癌药物的密闭式转移装置（CSTD），已被报道能够安全地为患者配制和使用这些药物。然而，在许多医疗机构，此类装置的使用仅限于某些抗癌药物。这可能是由于与传统的注射器和针头注射技术相比，其配制时间更长，以及抗癌药物过于昂贵，医疗服务的报酬无法覆盖。在此背景下，我们测量了配制环磷酰胺（CPA）所需的时间并估算了成本。我们的结果表明，单剂量100mg CPA或100mg CPA与500mg另一种药物组合（100mg + 500mg组）的配制时间明显长于单剂量500mg单一药物的配制时间。另一方面，使用CSTD可降低转换为单剂量500mg时的总成本（药物成本 + CSTD成本），5年节省如下：ChemoCLAVE®为3,755,217日元，PhaSeal®为6,302,622日元，Chemosafe®为2,698,451日元。这些发现表明，包括大标准剂量CPA在内的药物的适当选择，可缩短配制时间，降低总药物成本以及CSTD成本。
